WHEW! I'm safe: Doctors Advise Circumcision to Prevent HIV Spread]

From: Michael S. Lorrey (retroman@turbont.net)
Date: Fri Jun 09 2000 - 14:48:31 MDT

Thursday June 8 7:17 PM ET

Doctors Advise Circumcision to Prevent HIV Spread

By Patricia Reaney

LONDON (Reuters) - Australian doctors recommended male circumcision Friday
as a means to prevent the spread of the HIV virus that causes AIDS.

Their review of previous studies of circumcision and HIV showed that the
virus is usually passed through the penis and that men who have been
circumcised are two to eight times less likely to become infected with HIV.

``Male circumcision should be seriously considered as an additional means
of preventing HIV in all countries with a high prevalence of infection,''
Professor Roger Short of the University of Melbourne wrote in a report in
the British Medical Journal.

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Short and his colleagues acknowledged that cultural and religious attitudes
play a major role in circumcision in many countries but said mounting
evidence has proven the benefits.

Although circumcising babies is the least complicated procedure, it would
not have an impact on HIV transmission rates for 15 to 20 years. The
researchers suggested circumcising teenaged boys would be much more effective.

``Circumcision at puberty, as practiced by many Muslim communities, would
be the most immediately effective intervention for reducing HIV
transmission since it would be done before young men are likely to become
sexually active,'' Short said.

How circumcision prevents HIV infection is still a mystery, but Short and
his colleagues believe the inner surface of the foreskin could be the route.

The foreskin -- removed during circumcision -- contains cells that have HIV
receptors which the researchers suspect are the primary entry point for the
virus into the penis.

Half of the estimated 50 million people worldwide infected with the HIV
virus are men and most have been infected through their penis.

``The inner surface of the foreskin, which is rich in HIV receptors and the
frenulum (a thin band connecting the inner foreskin) must be regarded as
the most probable sites for viral entry in primary HIV infection in men,''
Short said.

Although they were confident circumcision would help, the researchers said
other methods were also needed.

``The development of topically active agents that can block HIV binding
sites, such as CCR5, and which could be applied to the penis or vagina to
create a chemical condom, might be more effective and acceptable than any
mechanical or surgical intervention,'' Short added.

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